Cardinal and Uterosacral Ligaments

Cardinal and Uterosacral Ligaments


The cardinal ligaments are fibromuscular bands embedded in the adipose tissue of the lower portion of the broad ligaments. These bands extend from the lower portion of the cervix and upper portion of the vagina across the pelvic floor as a deeper continuation of the broad ligament. As the ligaments reach the lateral pelvic diaphragm, their ventral and dorsal extensions attach to the deep fascia on the inner surface of the levator ani, coccygeus, and piriformis muscles. This forms a white line 2 cm below the arcus tendineus of the levator ani, which is called the arcus tendineus of the pelvic fascia. Ventral extension is continuous with the supporting tissue of the bladder, whereas the dorsal extension blends with the uterosacral ligaments.

The uterosacral ligaments are the prominent fibrous bands extending from the cervix to the sacrum. They are attached to the periosteum and fascia of the sacrum. The peritoneum surrounding the ligaments creates the rectouterine folds that enclose the pouch of Douglas.

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